Individual provider Active NPI

Renee Phillips

  • Pediatric Occupational Therapist
  • Idaho Falls, ID
National Provider Identifier
1447141635
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
6371661 Issued in ID
Practice address
586 1St St
Idaho Falls, ID 83401-3929
Phone
(208) 523-6988
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 6371661 ID Primary

Addresses

Primary practice location

586 1St St
Idaho Falls, ID 83401-3929

Mailing address

1437 Alayssa Dr
Idaho Falls, ID 83402-5234
Phone (208) 313-5123

Other names 1

  • Renee Estrada Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251229002721 ID Practitioner - Occupational Therapist in Private Practice 2264928233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Achieve Therapy and Learning Services, LLCGroup PAC ID 7113382110, 8 clinicians

Practice addresses (Care Compare)

586 1St St
Idaho Falls, ID 83401-3963
Phone (208) 523-6988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6371661IDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Therapy and Learning Services, LLC CurrentSince Sep 20, 2025 Accepting new patients

Locations

586 1st St
Idaho Falls, ID 83401
Phone (208) 523-6988

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1447141635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 ALAYSSA DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834025234",
            "telephone_number": "208-313-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 1ST ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013929",
            "telephone_number": "208-523-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ID",
            "license": "6371661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "ESTRADA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.